老年高血压病患者血清肿瘤坏死因子-α、白介素-6和C-反应蛋白水平的变化研究

目的 探讨在老年高血压病患者中,血清肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)和白细胞介素-6( IL-6)水平变化及意义.方法 24例正常血压老年人和28例老年高血压病患者,常规测量血压,抽取空腹静脉血检测其空腹血糖、血脂、血清胰岛素、IL-6、CRP和TNF-α水平.结果 与正常老年人群相比,在老年高血压者中,血清总胆固醇、三酰甘油、IL-6[(15.56±5.36)vs(26.86±2.49)μg/ml,P＜0.05]、CRP[(1.58±1.14)vs(2.29±1.42)mg/ml,P＜0.05]和TNF-α[(34.58±14.54)vs(56.82±32.14)ng/ml,P＜0.05]水平均高于正常血压人群.在老年高血压病患者中,血清CRP和TNF-α水平均与收缩压呈正相关,与舒张压无相关性.结论 老年高血压病患者中血清IL-6、CRP和TNF-α水平均增高并与收缩压呈正相关,提示高血压病与炎症密切相关.     

高血压患者血清白细胞介素-18和C反应蛋白水平检测的临床意义

目的:研究检测高血压病患者血清白细胞介素-18(IL-18)和C反应蛋白(CRP)的临床意义。方法:选择168例高血压患者和58例健康体检者,以酶联免疫吸附试验(ELISA)法和免疫比浊法检测其血清IL-18和CRP水平,分析其与高血压的相关性和临床意义。结果:与正常对照组比较,高血压病(1~3级)各组血清IL-18[(120.7±76.4)ng/L:(224.8±80.7)ng/L:(478.9±184.1)ng/L:(669.1±210.3)ng/L]、CRP[(2.4±1.6)mg/L:(5.9±3.8)mg/L:(24.1±12.6)mg/L:(41.6±16.5)mg/L]水平均显著升高(P均0.01);且随高血压分级水平升高,血清IL-18及CRP水平均逐渐升高(P0.01)。结论:血清白细胞介素-18、C反应蛋白水平与高血压的发病及分级水平有关,其测定很有意义。     

慢性乙型肝炎病毒感染者血清MIF、IL-17和IL-10水平变化

目的探讨HBV感染者外周血巨噬细胞移动抑制因子(MIF)、IL-17和IL-10水平变化的临床意义。方法收集60例慢性无症状HBV携带者、60例慢性乙型肝炎患者、60例乙型肝炎肝硬化患者、60例肝癌患者和50例健康对照者空腹血清,采用ELISA法检测血清MIF、IL-17和IL-10水平;采用荧光定量PCR法检测血清HBV DNA载量;采用全自动生化分析仪检测血清肝功能指标。结果与健康对照组[(1.9±1.4)ng/ml]比,ASC组、CHB组、LC组和HCC组外周血MIF水平均显著升高[分别为(5.7±2.8)ng/ml、(10.5±4.1)ng/ml、(17.7±7.4)ng/ml、(19.8±9.9)ng/ml,P0.01],其中HCC组最高,ASC组最低;与健康对照组[(4.4±2.2)ng/ml]比,ASC组、CHB组、LC组和HCC组外周血IL-17水平均显著升高[分别为(8.6±4.3)ng/ml、(20.7±6.6)ng/ml、(23.4±15.1)ng/ml、(16.0±8.7)ng/ml,P0.01或P0.05],其中LC组最高,ASC组最低;与健康对照组[(12.9±4.6)ng/ml]比,ASC组、CHB组、LC组和HCC组外周血IL-10水平均显著升高[分别为(237.2±72.9)ng/ml、(184.68±59.0)ng/ml、(356.6±150.8)ng/ml、(287.9±88.8)ng/ml,P0.01],其中LC组最高,CHB组最低。结论 MIF、IL-17和IL-10在慢性HBV感染过程中可能起重要作用,检测血清细胞因子水平可作为评估慢性乙型肝炎病情严重程度的重要指标。     

不同性质颈动脉粥样斑块患者的血清炎性因子、神经细胞因子的含量变化及相关分析

目的:研究不同性质颈动脉粥样斑块患者的血清炎性因子、神经细胞因子的含量及相关性。方法:选择2012年4月~2014年4月期间在我院体检的健康者40例作为健康对照组,经超声检查确诊为颈动脉粥样稳定斑块和不稳定斑块的患者分别作为稳定斑块组(40例)和不稳定斑块组(40例)。检测比较各组血清炎性因子[C反应蛋白(CRP)、基质金属蛋白酶-9(MMP-9)、同型半胱氨酸(Hcy)]、神经细胞因子[脑源性神经营养因子(BDNF)、神经生长因子(NGF)、S100β蛋白、神经元特异性烯醇酶(NSE)]的含量,并分析炎性因子与神经细胞因子含量的相关性。结果:与健康对照组比较,稳定斑块组和不稳定斑块组血清CRP[(1.10±0.14)mg/L比(5.92±0.72)mg/L比(12.46±1.67)mg/L]、MMP-9[(93.48±10.12)μg/L比(234.56±37.72)μg/L比(419.39±55.48)μg/L]、Hcy[(8.39±0.92)μmol/L比(15.48±1.95)μmol/L比(28.61±3.38)μmol/L]、S100β[(0.56±0.07)ng/ml比(0.91±0.10)ng/ml比(1.52±0.19)ng/ml]和NSE[(13.41±1.85)ng/ml比(17.38±2.08)ng/ml比(35.34±4.98)ng/ml]含量均显著升高,BDNF[(8.84±0.92)pg/ml比(7.23±0.91)pg/ml比(3.75±0.49)pg/ml]和NGF[(234.25±34.62)ng/ml比(189.34±22.87)ng/ml比(93.48±10.19)ng/ml]含量均显著减低,且与稳定斑块组比较,不稳定斑块组血清CRP、MMP-9、Hcy、S100β和NSE含量升高更显著,BDNF和NGF含量降低更显著,P0.05或0.01。一元线性回归分析显示,血清CRP、MMP-9和Hcy含量与BDNF、NGF含量呈显著负相关(r=-0.810~-0.691,P0.05或0.01),与S100β、NSE含量呈显著正相关(r=0.687~0.804,P0.05或0.01)。结论:不稳定颈动脉粥样斑块患者血清中炎性因子CRP、MMP-9、Hcy的含量显著升高,并且与神经细胞因子含量存在相关关系。     

类风湿关节炎患者血清可溶性人白细胞抗原-Ⅰ类抗原的检测分析

目的 探讨山西汉族人群血清可溶性人白细胞抗原-Ⅰ (sHLA-Ⅰ)水平与类风湿关节炎(RA)的关系.方法 酶联免疫吸附测定(ELISA)法检测血清sHLA-Ⅰ类抗原水平.将不同浓度的标准品和待检血清分别加人包被有特异性sHLA-Ⅰ抗体的酶标板,与生物素化的sHLA-Ⅰ、辣根过氧化物酶(HRP)标记的链霉亲和素共同孵育,弃上清并用洗涤液洗涤,加底物应用液四甲基联苯胺(TMB)显色,以酶标仪450 nm测定吸光度(A)值,根据不同浓度标准品显色后测得的A值绘制标准曲线.测定RA患者与健康人的sHLA-Ⅰ含量.结果 ①血清sHLA-Ⅰ类抗原水平:80名健康人为(390±106)ng/ml;80例RA患者为(632±169)ng/ml,其中50例活动期RA患者为(739±144)ng/ml,30例缓解期RA患者为(524±114)ng/ml,与健康人相比,活动期和缓解期RA患者血清sHLA-Ⅰ均显著增高(P＜0.01),且活动期RA患者显著高于缓解期患者(P＜0.0).②26例活动期RA患者治疗前血清sHLA-Ⅰ类抗原水平为(744±148)ng/ml,经治疗病情缓解后为(533±106)ng/ml,治疗前显著高于治疗后(P＜0.01).结论 RA患者血清sHLA-Ⅰ类抗原水平明显增高,且以活动期增高更为显著.     

血清白细胞介素-17检测在类风湿关节炎中的临床意义

目的 研究白细胞介素(IL)-17在活动期类风湿关节炎(RA)患者血清中水平变化及意义,探讨IL-17在RA的临床意义.方法 ①用酶联免疫吸附法(ELISA)检测51例活动期RA患者(RA组)血清IL-17水平,分析其IL-17水平与临床指标的关系.②检测30例活动期RA患者(治疗组)经来氟米特(LEF)治疗前后IL-17水平变化,分析其与lI缶床指标的关系.采用成组t检验,重复测量的方差分析,单因素方差分析及Spearman相关分析进行统计学处理.结果 ①RA组血清IL-17浓度为(365±63)pg/ml,高于健康对照组(86±13)pg/ml;治疗后较治疗前下降,差异有统计学意义(P<0.01);②RA组血清IL-17水平与晨僵时间、肿胀指数、压痛指数、C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)、X线分期评分、疾病活动度积分(DAS28)呈正相关(r值分别为:0.423,0.213,0.252,0.276,0.346,0.251,0.412,0.398;P均<0.05);③RA组不同x线分期:I期[(296±79)ps/L]与Ⅱ期[(360±89)pg/L]、Ⅱ期与Ⅲ期[(464±74)ps/L]、Ⅲ期与Ⅳ期[(369±83)pg/L]IL-17水平比较差异均有统计学意义(P<0.05).结论 活动期RA患者血清IL-17的水平比健康人升高,血清IL-17水平可作为RA活动性参考指标之一;血清IL-17水平变化可为RA疗效提供参考;IL-17参与RA的发病和骨侵蚀,可能是治疗RA的重要靶标.     

肝癌患者可溶性肿瘤坏死因子受体Ⅱ检测的临床意义

目的 进一步了解肝癌患者的异常免疫状态,探讨血清、腹水sTNFRⅡ检测的临床意义.方法 用双单抗夹心酶免疫吸附法检测25例肝癌、25例肝硬化患者血清腹水中和30例正常人血清sTNFR Ⅱ水平.结果 肝癌病人血清sTNFR Ⅱ浓度[(9.39±4.10)ng/ml]显著高于正常人和肝硬化患者(P＜0.01),同时肝硬化患者血清sTNFR Ⅱ浓度[(0.58±0.18)ng/ml]明显高于正常人[(0.31±0.16)ng/ml,P＜0.01].肝癌病人腹水sTNFRⅡ浓度[(9.13±5.26)ng/ml]亦显著高于肝硬化腹水sTNFR Ⅱ水平[(0.52±0.15)ng/ml,P＜0.01].肝癌、肝硬化患者血清、腹水sTNFR Ⅱ水平显著相关(r=1.00,P=0.00).肝癌血清sTNFRⅡ水平与外周血AFP和血小板数量呈正相关(r=0.432,P=0.05和r=0.513,P=0.03).结论 sTNFRⅡ的检测对反映肝癌患者的异常免疫状态,对肿瘤诊断具有实用价值.     

幼年特发性关节炎患儿基质金属蛋白酶及细胞因子的改变及意义

目的 探讨幼年特发性关节炎(JIA)多关节型患儿血清及关节液基质金属蛋白酶(MMP)-I、MMP-3、金属蛋白酶抑制剂(TIMP)-1、白细胞介素(IL)-1、肿瘤坏死因子(TNF)-α,转化生长因子(TGF)-β水平的变化及临床意义.方法 酶联免疫吸附试验(ELISA)检测32例多关节型JIA患儿及28例对照组(外伤性关节炎患儿)血清及关节液中MMP-1、MMP-3、TIMP-1、IL-1、TNF-α、TGF-β的水平.同时检测血白细胞计数、C反应蛋白(CRP)、红细胞沉降率(ESR)及类风湿因子(RF)水平.统计学方法采用两个独立样本的t检验及Pearson直线相关分析.结果 ①JIA组血清MMP-1、MMP-3、IL-1、TNF-α水平分别为(158±67) ng/ml、(212±89) ng/ml、(39±19) pg/ml、(26±10) pg/ml,明显高于对照组(P均＜0.05),MMP-3/TIMP-1为0.86±0.32,亦较对照组升高(P＜0.05),TIMP-1、TGF-β水平分别为(248±88)、(17±9)ng/ml,明显低于对照组(P均＜0.05);血清MMP-3、MMP-3/TlMP-1与白细胞计数、CRP、ESR呈正相关(P均＜0.05).②JIA组关节液MMP-1、MMP-3、IL-1、TNF-α水平分别为(216±78) ng/ml、(766±291) ng/ml、(56±21) pg/ml、(36±14) pg/ml,明显高于对照组(P均＜0.05),MMP-3/TIMP-1为2.68±0.89,亦较对照组明显升高(P＜0.05),TIMP-1、TGF-β水平分别为(286±88)、(12±4) ng/ml,明显低于对照组(P均＜0.05).③JIA组关节液MMP-1、MMP-3、TIMP-1、IL-1、TNF-α水平明显高于其血清水平(P均＜0.05),TGF-β水平则明显低于其血清水平(P＜0.05).结论 血清及关节液中MMP-1、MMP-3、IL-1、TNF-α水平升高,TIMP-1永平降低,参与了JIA多关节型的发病过程,TGF-β水平降低,在其发病中可能起保护作用.血清MMP-3/ⅡMP-1比值与JIA炎性指标呈正相关,有助于判断病情活动性.     

类风湿关节炎血清白细胞介素17检测的临床意义

目的 检测类风湿关节炎(rheumatoid arthritis,RA)患者血清白细胞介素(IL)-17的水平,探讨其在RA临床中的意义.方法 收集2007年1月至12月大连医科大学附属第二医院门诊及住院RA患者84例,采用免疫酶联吸附(ELISA)方法检测血清IL-17水平;同时检测血清C-反应蛋白(C reactive protein,CRP)、葡萄糖-6-磷酸异构酶(glucose-6-phosphate isomerase,GPI)、类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸多肽(anti-cyclic citrolli-natad peptide,anti-CCP)抗体、IL-1β和肿瘤坏死因子-a(tumor necrosis factor-a,TNF-a)水平;并分析IL-17与RA临床炎症指标和实验室指标的相关性.结果 活动期RA患者血清IL-17为(113.8+21.7)ng/L,高于非活动期RA患者[(76.3+11.9)ng/L]和正常对照组[(62.6+8.6)ng/L],差异有统计学意义(均P<0.05).RA患者血清IL-17水平分别与CRP和RF呈正相关,与IL-1β和TNF-a也有正相关关系(均P<0.05),但与自身抗原GPI和抗CCP抗体无相关性(P均>0.05);RA组血清IL-17水平与临床活动指标也有相关性.结论 RA患者血清IL-17表达增高,并与病情活动有关.     

左卡尼汀联合环磷腺苷对病毒性心肌炎患者的疗效及对IFN-γ和IL-4水平的影响

目的:观察左卡尼汀联合环磷腺苷对病毒性心肌炎(VMC)患者的疗效及对血清干扰素(IFN)-γ和白介素(IL)-4水平的影响。方法:2017年到2018年于我院治疗的VMC患者132例被随机均分为左卡尼汀组(在常规治疗基础上接受左卡尼汀治疗)和联合治疗组(在左卡尼汀组基础上接受环磷腺苷治疗),两组均治疗2周。观察比较两组治疗前、后外周血血清IFN-γ、IL-4、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)水平,临床疗效以及药物不良反应。结果:与治疗前比较,治疗2周后两组血清IL-4水平均显著升高,血清IFN-γ、cTnT和CK-MB水平均显著降低,P均=0.001;与左卡尼汀组比较,联合治疗组血清IL-4水平[(47.43±9.17)ng/ml比(55.38±10.23)ng/ml]升高更显著,血清IFN-γ[(65.22±11.82)ng/ml比(52.18±10.06)ng/ml]、cTnT[(0.37±0.09)ng/ml比(0.18±0.03)ng/ml]和CK-MB[(28.56±5.34)U/L比(16.22±3.47)U/L]水平降低更显著,P均=0.001。联合治疗组治疗总有效率显著高于左卡尼汀组(92.4%比80.3%),P=0.042。两组药物不良反应率无显著差异,P=0.784。结论:左卡尼汀联合环磷腺苷可以显著降低病毒性心肌炎患者外周血IFN-γ水平和升高IL-4水平,调节Th1/Th2失衡,疗效显著,安全性好。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.